ImmuneWise Pre-Survey
Exit this survey
1.
1
. Does your program currently have an immunization advocacy project?
Does your program currently have an immunization advocacy project?
Yes
No
2
. Has your program ever had an immunization advocacy project?
Has your program ever had an immunization advocacy project?
Yes
No
3
. If yes to the above select which best applies:
If yes to the above select which best applies:
Individual level
Program/Clinic level
Community level
State level
National level
4
. Does your program have an immunization education curriculum in place?
Does your program have an immunization education curriculum in place?
Yes
No
5
. Has your program had a presentation with the subject of vaccines or vaccine preventable illness during a Grand Rounds or other setting?
Has your program had a presentation with the subject of vaccines or vaccine preventable illness during a Grand Rounds or other setting?
Yes
No
6
. Does your clinic have large numbers of parents refusing vaccines?
Does your clinic have large numbers of parents refusing vaccines?
Yes
No
7
. If so, what reasons do they give, select the best answer:
If so, what reasons do they give, select the best answer:
Concerns of autism
Religious reasons
Prior adverse event
Concerns regarding the schedule
Other (please specify)
8
. Does your program require residents to develop and maintain Quality Improvement projects?
Does your program require residents to develop and maintain Quality Improvement projects?
Yes
No
9
. If so, are any of these projects currently focused on improving vaccine rates in your clinic?
If so, are any of these projects currently focused on improving vaccine rates in your clinic?
Yes
No
10
. If so, are any of these projects focused on educating your community on vaccine safety or vaccine education?
If so, are any of these projects focused on educating your community on vaccine safety or vaccine education?
Yes
No
11
. Does your clinic use the Vaccine Adverse Effects Reporting System (VAERS)?
Does your clinic use the Vaccine Adverse Effects Reporting System (VAERS)?
Yes
No
12
. If no, is there a system in place so that all vaccine adverse events are reported?
If no, is there a system in place so that all vaccine adverse events are reported?
Yes
No
13
. Are you aware that the AAP program delegate to the NCE is responsible for presenting the “ImmuneWise Noon Conference” presentation to your program (this presentation is located on the CDRom that was distributed at the NCE and available on line at www.aap.org/ypn/r/advocacy
Are you aware that the AAP program delegate to the NCE is responsible for presenting the “ImmuneWise Noon Conference” presentation to your program (this presentation is located on the CDRom that was distributed at the NCE and available on line at www.aap.org/ypn/r/advocacy
Yes
No
14
. Prior to taking this questionnaire were you aware of the Advocacy Modules on the AAP Web site?
Prior to taking this questionnaire were you aware of the Advocacy Modules on the AAP Web site?
Yes
No
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